Crucial factors affecting longevity
Authors: Renata Sisto
Journal: The Lancet Healthy Longevity (2023)

Even before the advent of modern medical treatments, a healthy lifestyle was known to improve quality of life and to prolong life expectancy. The contribution of a healthy lifestyle could soon be given a quantitative value by means of epidemiological models that estimate the effect of different lifestyle variables on quality of life and life expectancy, which could allow policy makers to make important strides in the promotion of population-level health.1Newman AB Murabito JM The epidemiology of longevity and exceptional survival.Epidemiol Rev. 2013; 35: 181-197Crossref PubMed Scopus (86) Google Scholar, 2Montesanto A Dato S Bellizzi D Rose G Passarino G Epidemiological, genetic and epigenetic aspects of the research on healthy ageing and longevity.Immun Ageing. 2012; 9: 6Crossref PubMed Scopus (0) Google Scholar Several variables beyond a healthy lifestyle are known to influence longevity. The sum of exposure to different xenobiotics and stress factors in the living and working environment accumulated during the individual lifespan, known as the exposome,3Wild CP The exposome: from concept to utility.Int J Epidemiol. 2012; 41: 24-32Crossref PubMed Scopus (789) Google Scholar, 4Vineis P Robinson O Chadeau-Hyam M Dehghan A Mudway I Dagnino S What is new in the exposome?.Environ Int. 2020; 143105887Crossref Scopus (73) Google Scholar affects both quality of life and longevity. The exposome can currently be correlated not only to clinical outcomes, but also to biomarkers of effect, which might help in the prevention and management of diseases and contribute to understanding the interactions of the human organism with environmental factors from a mechanistic viewpoint. Furthermore, the biomarkers of effect help to quantitatively define the susceptibility to damage of an individual exposed to environmental stressors. Health is the result of complex interactions between genes and the environment, wherein genes are modulated by the environment that epigenetically affects their expression. The interplay between the genome and gene expression modulation also plays a crucial role in longevity. Studies of populations with a large proportion of centenarians have helped to identify genes related to life expectancy,5Kuningas M Mooijaart SP van Heemst D Zwaan BJ Slagboom PE Westendorp RG Genes encoding longevity: from model organisms to humans.Aging Cell. 2008; 7: 270-280Crossref PubMed Scopus (0) Google Scholar, 6Niemi AK Moilanen JS Tanaka M et al.A combination of three common inherited mitochondrial DNA polymorphisms promotes longevity in Finnish and Japanese subjects.Eur J Hum Genet. 2005; 13: 166-170Crossref PubMed Scopus (0) Google Scholar and polymorphisms of such genes can be used to define indices of susceptibility and resistance to disease. In the interaction with the environment, polymorphic variations of crucial genes can greatly affect the risk of developing a given disease.7Sripichai O Fucharoen S Genetic polymorphisms and implications for human diseases.J Med Assoc Thai. 2007; 90: 394-398Google Scholar High consumption of alcohol, drugs, and tobacco are some of the lifestyle variables known to have toxic consequences on the organism and to greatly increase the risk of serious diseases. Growing attention is being paid to dietary intake, which can be an important driver of disease in the context of excessive assumption of unhealthy fats, refined sugar, and artificial food additives. For example, in some studies from low-income countries, a diet can be considered healthy if it contains a sufficient amount of animal protein, whereas in studies from high-income countries, excessive consumption of protein from meat, fish, cheese, and eggs is often considered a risk factor. This dichotomy is a stark reminder of how much socioeconomic wellbeing is still unbalanced across different geographic regions, and of the great extent to which such disparities can have consequences on health outcomes. Such imbalances, characterised by overconsumption of planetary resources in high-income countries, and limited or null access to basic subsistence products in low-income countries, can drive mortality in any income setting, albeit for opposite reasons—for example, with obesity pushing up deaths from heart disease in high-income countries, and malnutrition also contributing to deaths in low-income settings. Another important point to emphasise is the concept of an active lifestyle,8Reimers CD Knapp G Reimers AK Does physical activity increase life expectancy? A review of the literature.J Aging Res. 2012; 2012243958Crossref Scopus (90) Google Scholar which is a common notion in high-income countries—that is, a healthy lifestyle requires a sufficient amount of physical activity. In The Lancet Health Longevity, Jun Wang and colleagues9Wang J Chen C Zhou J et al.Healthy lifestyle at late-life, longevity genes, and life expectancy among older adults: a 20-year, population-based, prospective cohort study.Lancet Healthy Longevity. 2023; 4: e535-e543Google Scholar propose a unique score to define an active lifestyle, including physical, mental, and social activities. This definition of an active life including social activities is an important reminder that social connections have a vital role in the maintenance of brain function. From this point of view, high educational attainment not only facilitates access to the information needed to support a correct lifestyle, but also promotes stimuli from varied activities, such as reading, watching movies, and following and discussing the news. In short, maintaining an active mind could be one of the essential factors to promote healthy longevity, and it can be achieved in different ways throughout the lifespan; a clear example of the importance of mental stimulation for brain health is the known correlation between hearing loss and cognitive decline and dementia.10Jiang F Mishra SR Shrestha N Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohort.Lancet Public Health. 2023; 8: e329-e338Summary Full Text Full Text PDF PubMed Scopus (9) Google Scholar Wang and colleagues’ study9Wang J Chen C Zhou J et al.Healthy lifestyle at late-life, longevity genes, and life expectancy among older adults: a 20-year, population-based, prospective cohort study.Lancet Healthy Longevity. 2023; 4: e535-e543Google Scholar also suggests that quality of life and life expectancy can be improved from active social connections, particularly for individuals who are less protected by their genetic heritage. Such a seemingly simple and inexpensive to modify factor should be held in consideration for the promotion of long-term health in the society of the future, and it could, alongside other known lifestyle factors, greatly contribute to reducing the burden of disease and premature deaths in a rapidly ageing population. I declare no competing interests. Healthy lifestyle in late-life, longevity genes, and life expectancy among older adults: a 20-year, population-based, prospective cohort studyA healthy lifestyle, even in late-life, was associated with lower mortality risk and longer life expectancy among Chinese older adults, highlighting the importance of a healthy lifestyle in extending the lifespan, especially for individuals with high genetic risk. Full-Text PDF Open Access